Determining Optimal Dose and Duration of Diuretic Treatment in People With Acute Heart Failure (The DOSE-AHF Study)

Diuretic Optimal Strategy Evaluation in Acute Heart Failure (The DOSE-AHF Study)

Status

Completed

Phases

Phase 3

Study type

Interventional

Source

ClinicalTrials.gov

Registry ID

NCT00577135

Enrollment

308

Registered

2007-12-19

Start date

2008-02-29

Completion date

2010-02-28

Last updated

2018-03-06

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Heart Failure

Keywords

Loop Diuretics, Furosemide, Fluid Overload, Cardio Renal Failure

Brief summary

Heart failure is a disorder in which the heart does not pump blood adequately. This can lead to several serious problems, including reduced blood flow throughout the body, congestion of blood in the veins and lungs, and fluid accumulation in various organs and limbs. Diuretics are often used to address the problem of fluid accumulation, but the optimal dose and the amount of time over which to administer each dose are unclear. This study will compare high and low doses of diuretics administered over longer and shorter periods of time to determine the safest and most effective combination.

Detailed description

Heart failure is a common disorder in which the heart cannot pump enough blood to meet the needs of the rest of the body. Heart failure symptoms include shortness of breath, swelling, and fatigue. Standard treatment for the swelling associated with heart failure includes the use of diuretic medications, such as furosemide, which cause urination and the removal of excess fluids in the body. Although furosemide has been used to treat heart failure patients for many years, it is still unclear how much of the drug to use, and over what time period the drug should be given. This study will evaluate whether furosemide treatment is safer and more effective when the drug is given in high doses versus low doses and in two to three separate doses versus one continuous infusion. Participants in this study will begin study procedures within the first 24 hours of their hospital admission for heart failure. Participants will be randomly assigned to receive one of the following four treatments: high dose furosemide via continuous intravenous (IV) infusion and placebo every 12 hours via IV bolus; low dose furosemide via continuous IV infusion and placebo every 12 hours via IV bolus; high dose furosemide every 12 hours via IV bolus and placebo via continuous IV infusion; and low dose furosemide every 12 hours via IV bolus and placebo via continuous IV infusion. Each participant will receive treatment for the first 72 hours of his or her hospital stay. Participants will answer questionnaires and undergo physical examinations and blood tests during the first 96 hours of hospitalization and again before hospital discharge or on Day 7, if that occurs first. Participants will be asked to return to their doctors 60 days following hospital discharge to evaluate their responses to treatment.

Interventions

DRUGFurosemide-Q12 hour bolus

Q12 hours bolus

DRUGFurosemide-Continuous Infusion

Continuous infusion

DRUGFurosemide-Low Intensification

1x oral dose

DRUGFurosemide-High Intensification

2.5x oral dose

Study design

Allocation

RANDOMIZED

Intervention model

FACTORIAL

Primary purpose

TREATMENT

Masking

TRIPLE (Subject, Caregiver, Investigator)

Eligibility

Sex/Gender

ALL

Age

18 Years to No maximum

Healthy volunteers

Inclusion criteria

* Prior clinical diagnosis of heart failure that was treated with daily oral loop diuretics for at least 1 month * Current diagnosis of heart failure, as defined by the presence of at least 1 symptom (dyspnea, orthopnea, or edema) AND 1 sign (rales on auscultation, peripheral edema, ascites, pulmonary vascular congestion on chest radiography) * Daily oral dose of furosemide between 80 mg and 240 mg (or equivalent) * Identified within 24 hours of hospital admission * Current treatment plan includes IV loop diuretics for at least 48 hours

Exclusion criteria

* Brain natriuretic peptide (BNP) less than 250 mg/mL or N-terminal prohormone brain natriuretic peptide (NT-proBNP) less than 1000 mg/mL * Received IV vasoactive treatment or ultra-filtration therapy for heart failure since initial presentation * Treatment plan during current hospitalization includes IV vasoactive treatment or ultra-filtration for heart failure * Substantial diuretic response to pre-randomization diuretic dosing such that higher doses of diuretics would be medically inadvisable * Systolic blood pressure less than 90 mm Hg * Serum creatinine level greater than 3.0 mg/dL at baseline or currently undergoing renal replacement therapy * Hemodynamically significant arrhythmias * Acute coronary syndrome within 4 weeks prior to study entry * Active myocarditis * Hypertrophic obstructive cardiomyopathy * Severe stenotic valvular disease * Restrictive or constrictive cardiomyopathy * Complex congenital heart disease * Constrictive pericarditis * Non-cardiac pulmonary edema * Clinical evidence of digoxin toxicity * Need for mechanical hemodynamic support * Sepsis * Terminal illness (other than heart failure) with expected survival time of less than 1 year * History of adverse reaction to the study drugs * Use of IV iodinated radiocontrast material within 72 hours prior to study entry or planned during hospitalization * Enrollment or planned enrollment in another randomized clinical trial during this hospitalization * Inability to comply with planned study procedures

Design outcomes

Primary

Measure	Time frame	Description
Patient Well Being, as Determined by a Visual Analog Scale	Measured at 72 hours	Global Visual Analog Scale Scale Range 0-7200; higher score is better
Change in Serum Creatinine	Measured at baseline and 72 hours	—

Secondary

Measure	Time frame	Description
Change in Weight	baseline and 96 hours	—
Proportion of Patients Free of Congestion	Measured at 72 hours	—
Dyspnea, as Determined by Visual Analog Scales	Measured at 24 hours	Global Visual Analog Scale Scale Range 0-2400; higher score is better
Change in Serum Creatinine	baseline and 24 hours	—
Change in Cystatin C	baseline and 72 hours	—
Patient Well Being, as Determined by a Visual Analog Scale	Measured at 24 hours	Global Visual Analog Scale Scale Range 0-2400; higher score is better
Dyspnea VAS	48 hours	Dyspnea Visual Analog Scale Scale Range 0-4800; higher score is better
Change in Uric Acid	baseline and 72 hours	—
Change in B-type Natriuretic Peptide	baseline and 72 hours	Change in NTproBNP
Change in NTproBNP	baseline and Day 7	—
Presence of Cardiorenal Syndrome	Within 72 hours	—
Treatment Failure	Within 72 hours	Treatment failure is defined as the patient met cardiorenal syndrome endpoint, worsening or persistent heart failure endpoint, patient died, or there was clinical evidence of overdiuresis requiring intervention within first 72 hours after randomization
Net Fluid Loss	Through 24 hours	—

Countries

Canada, United States

Participant flow

Participants by arm

Arm	Count
Q12 Hours Bolus & Low Intensification	74
Q12 Hours Bolus & High Intensification	82
Continuous Infusion & Low Intensification	77
Continuous Infusion & High Intensification	75
Total	308

Baseline characteristics

Characteristic	Q12 Hours Bolus & Low Intensification	Q12 Hours Bolus & High Intensification	Continuous Infusion & Low Intensification	Continuous Infusion & High Intensification	Total
Age, Continuous	67.4 years STANDARD_DEVIATION 12.4	65.2 years STANDARD_DEVIATION 13.8	64.5 years STANDARD_DEVIATION 14.1	67.2 years STANDARD_DEVIATION 14	66.0 years STANDARD_DEVIATION 13.6
Sex: Female, Male Female	18 Participants	23 Participants	23 Participants	18 Participants	82 Participants
Sex: Female, Male Male	56 Participants	59 Participants	54 Participants	57 Participants	226 Participants

Adverse events

Event type	EG000 affected / at risk	EG001 affected / at risk	EG002 affected / at risk	EG003 affected / at risk
deaths Total, all-cause mortality	— / —	— / —	— / —	— / —
other Total, other adverse events	0 / 0	0 / 0	0 / 0	0 / 0
serious Total, serious adverse events	69 / 156	67 / 152	76 / 151	60 / 157

Outcome results

Primary

Change in Serum Creatinine

Time frame: Measured at baseline and 72 hours

Population: Each analysis performed for this trial was done twice. The first analysis compared Q12hour versus continuous, the second analysis compared low intensification versus high intensification. The study was not testing the combined 4 way as a pre-specified analysis.

Arm	Measure	Value (MEAN)	Dispersion
Q 12 Hour Bolus	Change in Serum Creatinine	0.05 mg/dL	Standard Deviation 0.3
Continuous Infusion	Change in Serum Creatinine	0.07 mg/dL	Standard Deviation 0.3
Low Intensification	Change in Serum Creatinine	0.04 mg/dL	Standard Deviation 0.29
High Intensification	Change in Serum Creatinine	0.08 mg/dL	Standard Deviation 0.31

Primary

Patient Well Being, as Determined by a Visual Analog Scale

Global Visual Analog Scale Scale Range 0-7200; higher score is better

Time frame: Measured at 72 hours

Arm	Measure	Value (MEAN)	Dispersion
Q 12 Hour Bolus	Patient Well Being, as Determined by a Visual Analog Scale	4236 units on a scale	Standard Deviation 1440.4
Continuous Infusion	Patient Well Being, as Determined by a Visual Analog Scale	4372.7 units on a scale	Standard Deviation 1404.4
Low Intensification	Patient Well Being, as Determined by a Visual Analog Scale	4170.8 units on a scale	Standard Deviation 1436.3
High Intensification	Patient Well Being, as Determined by a Visual Analog Scale	4429.6 units on a scale	Standard Deviation 1401.4

Secondary

Change in B-type Natriuretic Peptide

Change in NTproBNP

Time frame: baseline and 72 hours

Arm	Measure	Value (MEAN)	Dispersion
Q 12 Hour Bolus	Change in B-type Natriuretic Peptide	-1316.2 pg/mL	Standard Deviation 4364.3
Continuous Infusion	Change in B-type Natriuretic Peptide	-1773.2 pg/mL	Standard Deviation 3827.5
Low Intensification	Change in B-type Natriuretic Peptide	-1193.8 pg/mL	Standard Deviation 4094.1
High Intensification	Change in B-type Natriuretic Peptide	-1881.6 pg/mL	Standard Deviation 4105.4

Secondary

Change in Cystatin C

Time frame: baseline and 72 hours

Arm	Measure	Value (MEAN)	Dispersion
Q 12 Hour Bolus	Change in Cystatin C	0.11 mg/L	Standard Deviation 0.3
Continuous Infusion	Change in Cystatin C	0.17 mg/L	Standard Deviation 0.35
Low Intensification	Change in Cystatin C	0.12 mg/L	Standard Deviation 0.35
High Intensification	Change in Cystatin C	0.17 mg/L	Standard Deviation 0.31

Secondary

Change in Cystatin C

Time frame: baseline and day 60

Arm	Measure	Value (MEAN)	Dispersion
Q 12 Hour Bolus	Change in Cystatin C	0.20 mg/L	Standard Deviation 0.51
Continuous Infusion	Change in Cystatin C	0.16 mg/L	Standard Deviation 0.43
Low Intensification	Change in Cystatin C	0.18 mg/L	Standard Deviation 0.47
High Intensification	Change in Cystatin C	0.18 mg/L	Standard Deviation 0.46

Secondary

Change in Cystatin C

Time frame: baseline and day 7

Arm	Measure	Value (MEAN)	Dispersion
Q 12 Hour Bolus	Change in Cystatin C	0.21 mg/L	Standard Deviation 0.43
Continuous Infusion	Change in Cystatin C	0.16 mg/L	Standard Deviation 0.48
Low Intensification	Change in Cystatin C	0.16 mg/L	Standard Deviation 0.48
High Intensification	Change in Cystatin C	0.21 mg/L	Standard Deviation 0.42

Secondary

Change in NTproBNP

Time frame: baseline and Day 7

Arm	Measure	Value (MEAN)	Dispersion
Q 12 Hour Bolus	Change in NTproBNP	-1133.3 pg/mL	Standard Deviation 4883.4
Continuous Infusion	Change in NTproBNP	-1552.0 pg/mL	Standard Deviation 4875.8
Low Intensification	Change in NTproBNP	-1037.2 pg/mL	Standard Deviation 5211.8
High Intensification	Change in NTproBNP	-1629.7 pg/mL	Standard Deviation 4524.6

Secondary

Change in NTproBNP

Time frame: baseline and Day 60

Arm	Measure	Value (MEAN)	Dispersion
Q 12 Hour Bolus	Change in NTproBNP	-1449.3 pg/mL	Standard Deviation 5010.1
Continuous Infusion	Change in NTproBNP	-1035.1 pg/mL	Standard Deviation 6962.9
Low Intensification	Change in NTproBNP	-1445.6 pg/mL	Standard Deviation 5805.3
High Intensification	Change in NTproBNP	-1038.5 pg/mL	Standard Deviation 6364.3

Secondary

Change in Serum Creatinine

Time frame: baseline and 48 hours

Arm	Measure	Value (MEAN)	Dispersion
Q 12 Hour Bolus	Change in Serum Creatinine	0.02 mg/dL	Standard Deviation 0.23
Continuous Infusion	Change in Serum Creatinine	0.05 mg/dL	Standard Deviation 0.26
Low Intensification	Change in Serum Creatinine	0.01 mg/dL	Standard Deviation 0.23
High Intensification	Change in Serum Creatinine	0.06 mg/dL	Standard Deviation 0.25

Secondary

Change in Serum Creatinine

Time frame: baseline and 96 hours

Arm	Measure	Value (MEAN)	Dispersion
Q 12 Hour Bolus	Change in Serum Creatinine	0.06 mg/dL	Standard Deviation 0.32
Continuous Infusion	Change in Serum Creatinine	0.05 mg/dL	Standard Deviation 0.32
Low Intensification	Change in Serum Creatinine	0.05 mg/dL	Standard Deviation 0.33
High Intensification	Change in Serum Creatinine	0.07 mg/dL	Standard Deviation 0.31

Secondary

Change in Serum Creatinine

Time frame: baseline and day 7

Arm	Measure	Value (MEAN)	Dispersion
Q 12 Hour Bolus	Change in Serum Creatinine	0.10 mg/dL	Standard Deviation 0.4
Continuous Infusion	Change in Serum Creatinine	0.04 mg/dL	Standard Deviation 0.32
Low Intensification	Change in Serum Creatinine	0.07 mg/dL	Standard Deviation 0.33
High Intensification	Change in Serum Creatinine	0.08 mg/dL	Standard Deviation 0.4

Secondary

Change in Serum Creatinine

Time frame: baseline and day 60

Arm	Measure	Value (MEAN)	Dispersion
Q 12 Hour Bolus	Change in Serum Creatinine	0.09 mg/dL	Standard Deviation 0.41
Continuous Infusion	Change in Serum Creatinine	0.07 mg/dL	Standard Deviation 0.45
Low Intensification	Change in Serum Creatinine	0.09 mg/dL	Standard Deviation 0.43
High Intensification	Change in Serum Creatinine	0.07 mg/dL	Standard Deviation 0.43

Secondary

Change in Serum Creatinine

Time frame: baseline and 24 hours

Arm	Measure	Value (MEAN)	Dispersion
Q 12 Hour Bolus	Change in Serum Creatinine	0.00 mg/dL	Standard Deviation 0.18
Continuous Infusion	Change in Serum Creatinine	0.01 mg/dL	Standard Deviation 0.17
Low Intensification	Change in Serum Creatinine	-0.01 mg/dL	Standard Deviation 0.16
High Intensification	Change in Serum Creatinine	0.02 mg/dL	Standard Deviation 0.19

Secondary

Change in Uric Acid

Time frame: baseline and day 7

Arm	Measure	Value (MEAN)	Dispersion
Q 12 Hour Bolus	Change in Uric Acid	0.40 mg/dL	Standard Deviation 1.47
Continuous Infusion	Change in Uric Acid	0.09 mg/dL	Standard Deviation 1.96
Low Intensification	Change in Uric Acid	0.07 mg/dL	Standard Deviation 1.69
High Intensification	Change in Uric Acid	0.42 mg/dL	Standard Deviation 1.75

Secondary

Change in Uric Acid

Time frame: baseline and 72 hours

Arm	Measure	Value (MEAN)	Dispersion
Q 12 Hour Bolus	Change in Uric Acid	0.30 mg/dL	Standard Deviation 1.02
Continuous Infusion	Change in Uric Acid	0.44 mg/dL	Standard Deviation 1.2
Low Intensification	Change in Uric Acid	0.11 mg/dL	Standard Deviation 1.01
High Intensification	Change in Uric Acid	0.61 mg/dL	Standard Deviation 1.15

Secondary

Change in Uric Acid

Time frame: baseline and Day 60

Arm	Measure	Value (MEAN)	Dispersion
Q 12 Hour Bolus	Change in Uric Acid	-0.09 mg/dL	Standard Deviation 2.28
Continuous Infusion	Change in Uric Acid	-0.71 mg/dL	Standard Deviation 2.27
Low Intensification	Change in Uric Acid	-0.13 mg/dL	Standard Deviation 2.33
High Intensification	Change in Uric Acid	-0.67 mg/dL	Standard Deviation 2.24

Secondary

Change in Weight

Time frame: baseline and 96 hours

Arm	Measure	Value (MEAN)	Dispersion
Q 12 Hour Bolus	Change in Weight	-8.0 lbs	Standard Deviation 7.8
Continuous Infusion	Change in Weight	-9.1 lbs	Standard Deviation 10.2
Low Intensification	Change in Weight	-7.4 lbs	Standard Deviation 10.1
High Intensification	Change in Weight	-9.6 lbs	Standard Deviation 7.9

Secondary

Dyspnea, as Determined by Visual Analog Scales

Global Visual Analog Scale Scale Range 0-2400; higher score is better

Time frame: Measured at 24 hours

Arm	Measure	Value (MEAN)	Dispersion
Q 12 Hour Bolus	Dyspnea, as Determined by Visual Analog Scales	1370.8 units on a scale	Standard Deviation 486
Continuous Infusion	Dyspnea, as Determined by Visual Analog Scales	1453.8 units on a scale	Standard Deviation 518
Low Intensification	Dyspnea, as Determined by Visual Analog Scales	1426.0 units on a scale	Standard Deviation 504.5
High Intensification	Dyspnea, as Determined by Visual Analog Scales	1398.2 units on a scale	Standard Deviation 502.7

Secondary

Dyspnea VAS

Dyspnea Visual Analog Scale Scale Range 0-4800; higher score is better

Time frame: 48 hours

Arm	Measure	Value (MEAN)	Dispersion
Q 12 Hour Bolus	Dyspnea VAS	2876.6 units on a scale	Standard Deviation 960.1
Continuous Infusion	Dyspnea VAS	3033.1 units on a scale	Standard Deviation 1039.3
Low Intensification	Dyspnea VAS	2924.9 units on a scale	Standard Deviation 1012.8
High Intensification	Dyspnea VAS	2981.3 units on a scale	Standard Deviation 992.9

Secondary

Dyspnea VAS

Dyspnea Visual Analog Scale Scale Range 0-7200; higher score is better

Time frame: 72 hours

Arm	Measure	Value (MEAN)	Dispersion
Q 12 Hour Bolus	Dyspnea VAS	4455.6 units on a scale	Standard Deviation 1468.4
Continuous Infusion	Dyspnea VAS	4699.1 units on a scale	Standard Deviation 1572.7
Low Intensification	Dyspnea VAS	4477.9 units on a scale	Standard Deviation 1549.7
High Intensification	Dyspnea VAS	4668.3 units on a scale	Standard Deviation 1496

Secondary

Net Fluid Loss

Time frame: Through 48 hours

Arm	Measure	Value (MEAN)	Dispersion
Q 12 Hour Bolus	Net Fluid Loss	2996.7 mL	Standard Deviation 2490.5
Continuous Infusion	Net Fluid Loss	3120.6 mL	Standard Deviation 2504.2
Low Intensification	Net Fluid Loss	2334.8 mL	Standard Deviation 2006.4
High Intensification	Net Fluid Loss	3747.4 mL	Standard Deviation 2716.1

Secondary

Net Fluid Loss

Time frame: Through 24 hours

Arm	Measure	Value (MEAN)	Dispersion
Q 12 Hour Bolus	Net Fluid Loss	1595.7 mL	Standard Deviation 1476.7
Continuous Infusion	Net Fluid Loss	1796.4 mL	Standard Deviation 1685.1
Low Intensification	Net Fluid Loss	1209.7 mL	Standard Deviation 1309.3
High Intensification	Net Fluid Loss	2149.6 mL	Standard Deviation 1681.7

Secondary

Net Fluid Loss

Time frame: Through 72 hours

Arm	Measure	Value (MEAN)	Dispersion
Q 12 Hour Bolus	Net Fluid Loss	4236.7 mL	Standard Deviation 3207.6
Continuous Infusion	Net Fluid Loss	4249.2 mL	Standard Deviation 3104.3
Low Intensification	Net Fluid Loss	3575.2 mL	Standard Deviation 2634.8
High Intensification	Net Fluid Loss	4898.9 mL	Standard Deviation 3478.5

Secondary

Patient Well Being, as Determined by a Visual Analog Scale

Global Visual Analog Scale Scale Range 0-4800; higher score is better

Time frame: 48 hours

Arm	Measure	Value (MEAN)	Dispersion
Q 12 Hour Bolus	Patient Well Being, as Determined by a Visual Analog Scale	2722.6 units on a scale	Standard Deviation 940
Continuous Infusion	Patient Well Being, as Determined by a Visual Analog Scale	2792.6 units on a scale	Standard Deviation 932.7
Low Intensification	Patient Well Being, as Determined by a Visual Analog Scale	2706.5 units on a scale	Standard Deviation 931.5
High Intensification	Patient Well Being, as Determined by a Visual Analog Scale	2805.2 units on a scale	Standard Deviation 939.8

Secondary

Patient Well Being, as Determined by a Visual Analog Scale

Global Visual Analog Scale Scale Range 0-2400; higher score is better

Time frame: Measured at 24 hours

Arm	Measure	Value (MEAN)	Dispersion
Q 12 Hour Bolus	Patient Well Being, as Determined by a Visual Analog Scale	1280.8 units on a scale	Standard Deviation 469.7
Continuous Infusion	Patient Well Being, as Determined by a Visual Analog Scale	1303.0 units on a scale	Standard Deviation 465.1
Low Intensification	Patient Well Being, as Determined by a Visual Analog Scale	1288.6 units on a scale	Standard Deviation 455.9
High Intensification	Patient Well Being, as Determined by a Visual Analog Scale	1294.8 units on a scale	Standard Deviation 478.4

Secondary

Presence of Cardiorenal Syndrome

Time frame: Within 72 hours

Arm	Measure	Value (NUMBER)
Q 12 Hour Bolus	Presence of Cardiorenal Syndrome	17.4 percentage of participants
Continuous Infusion	Presence of Cardiorenal Syndrome	19.2 percentage of participants
Low Intensification	Presence of Cardiorenal Syndrome	13.6 percentage of participants
High Intensification	Presence of Cardiorenal Syndrome	22.7 percentage of participants

Secondary

Proportion of Patients Free of Congestion

Time frame: Measured at 72 hours

Arm	Measure	Value (NUMBER)
Q 12 Hour Bolus	Proportion of Patients Free of Congestion	14.4 percentage of participants
Continuous Infusion	Proportion of Patients Free of Congestion	15.3 percentage of participants
Low Intensification	Proportion of Patients Free of Congestion	11.2 percentage of participants
High Intensification	Proportion of Patients Free of Congestion	18.2 percentage of participants

Secondary

Treatment Failure

Treatment failure is defined as the patient met cardiorenal syndrome endpoint, worsening or persistent heart failure endpoint, patient died, or there was clinical evidence of overdiuresis requiring intervention within first 72 hours after randomization

Time frame: Within 72 hours

Arm	Measure	Value (NUMBER)
Q 12 Hour Bolus	Treatment Failure	38.1 percentage of participants
Continuous Infusion	Treatment Failure	38.8 percentage of participants
Low Intensification	Treatment Failure	36.7 percentage of participants
High Intensification	Treatment Failure	40.0 percentage of participants

Source: ClinicalTrials.gov · Data processed: Mar 29, 2026

Determining Optimal Dose and Duration of Diuretic Treatment in People With Acute Heart Failure (The DOSE-AHF Study)

Conditions

Keywords

Brief summary

Detailed description

Related papers

Interventions

Sponsors

Study design

Eligibility

Inclusion criteria

Exclusion criteria

Design outcomes

Primary

Secondary

Countries

Participant flow

Participants by arm

Baseline characteristics

Adverse events

Outcome results

Change in Serum Creatinine

Patient Well Being, as Determined by a Visual Analog Scale

Change in B-type Natriuretic Peptide

Change in Cystatin C

Change in Cystatin C

Change in Cystatin C

Change in NTproBNP

Change in NTproBNP

Change in Serum Creatinine

Change in Serum Creatinine

Change in Serum Creatinine

Change in Serum Creatinine

Change in Serum Creatinine

Change in Uric Acid

Change in Uric Acid

Change in Uric Acid

Change in Weight

Dyspnea, as Determined by Visual Analog Scales

Dyspnea VAS

Dyspnea VAS

Net Fluid Loss

Net Fluid Loss

Net Fluid Loss

Patient Well Being, as Determined by a Visual Analog Scale

Patient Well Being, as Determined by a Visual Analog Scale

Presence of Cardiorenal Syndrome

Proportion of Patients Free of Congestion

Treatment Failure